Progress at Ilula!

As this is my fourth journey to Ilula I have to say that it is incredibly inspiring to see progress.  The first item to note is the road in Ilula is paved!  All the way from the highway to the hospital.  Randy and I did both note that a little bit of the ambience of Ilula was lost but of course it is best for patients and staff of the hospital as well as villagers.
The second bit of progress was the new Pharmacy Technician:  Gift is a Tumaini trained technician that assists Frank in the CTC with HIV medications and other functions. Frank truly has much documentation to care for as the medication management system is entirely manual; Gift is truly a gift!  They both hope to recieve training to electronically document anti-retrovirals- they have a computer and software and await the education.
The third piece of inspiring news is medications are listed on the back page of the chart (similar to our "blue books").  Although this is not a MAR per se, it is documentation that I have not seen before.  We still struggle on rounds to understand if the medication was administered or not but minimally a list is helpful!  Meds are documented in a separate notebook at the nursing station as nurses draw meds up at the station and document at the same time.  We have sadly seen many cryptococcal meningitis patients for which there is no medication available on campus.  At Ilula the drug of choice is fluconazole and the hospital is out of stock.  Patients families can buy the drug outside the hospital walls but it is $30 a day- this in a country where the average annual healthcare expenditure is $20/year- a significant problem with challenging solutions.
Finally, it is inspiring to have Astrid returning and teaching.  We sat down for 3 hours the other night and put together HIV medications 101- adults only- just information that you need to get started.  It was very helpful to both of us and we will give the lecture in the next day or two.  Emily, Sarah and Grace have all participated in a mobile clinic in the village.  Next couple of  days will bring Malaria Meds 101- DPQ is a second line agent here and we can all review.  I also hope to interview Frank Sanga the pharmacist along with our students- if I can get my technology to work I can show the video to pharmacy students.  Technology challenges are not trivial- at the present time, internet is not functional at Ilula and electricity is out on campus- we had a big storm last night.
Safari Njema to all of our second-half colleagues!  Jill